Can you get pregnant without a man ejaculating inside

Before ejaculation occurs, the male reproductive system releases pre-ejaculate (aka pre-cum), which is a type of lubrication produced specifically for sex. Pre-cum alone technically does not contain sperm, so the chances of getting pregnant from pre-cum are pretty low. However, they're not 100% zero, either.

Whether withdrawal is your main birth control method or it's a method you occasionally rely on, here's what you need to know about sperm, pre-cum, and semen when it comes to your chances of getting pregnant.

What Is Pre-cum, Exactly?

Pre-cum is fluid mostly made up of mucus, proteins, and enzymes meant to balance pH and make the male urethra less acidic to give sperm a better chance of surviving in the super acidic vagina.

"Pre-ejaculate fluid (pre-cum) is a normal part of physiology for lubrication produced by glands of the penis to facilitate sexual intercourse," says Mike Hsieh, M.D., urologist, and director of Men's Health Center at UC San Diego Health. "The penile glands producing the pre-ejaculate fluids do not produce sperm (sperm is made from the testicles), and it is believed that sperm found in the pre-ejaculate fluids are residual sperm inside the urethra from prior ejaculations."

In other words: Pre-cum doesn't usually have sperm in it, but it is possible for some sperm to be lurking there.

And according to Mitchell Creinin, M.D., gynecologist, and director of family planning at UC Davis Health, pre-cum involuntarily comes out before the person physically feels an orgasm and ejaculates. "Pre-cum is really just the beginning of the ejaculate—there is no 'pre'," says Dr. Creinin.

Is There Sperm in Pre-cum?

The pre-cum fluid itself does not contain sperm, but sperm can leak into it as it travels down the urethra, where residuals may be present from previous ejaculations and can be released with pre-cum prior to semen. (FYI: Semen contains sperm and is the ejaculate that is emitted during orgasm.)

"Normal semen fluid from ejaculation contains greater than 40 million motile sperms compared to pre-ejaculate fluid, which has anywhere from no sperm to less than 5 million swimmers," says Dr. Hsieh.

The research on pre-cum and if it contains sperm is limited. For instance, a small 2013 study done on sperm counts of pre-cum in 27 males found that 41% of the participants had sperm in their pre-cum, with 37% of that being motile (healthy) sperm, while a similar 2016 study on sperm count in pre-cum found healthy sperm in about 17% of participants. But a 2021 study wasn't able to uncover anything conclusive about sperm in pre-cum, confirming that this question is one that still needs more research.

Can You Increase the Effectiveness of the Withdrawal Method?

Basically, the withdrawal method is not iron-clad. "The advice I try to give couples is that if you're seriously using withdrawal, you have to be comfortable as a couple with the idea of not fully finishing sex," says Dr. Creinin. "If you are going to enter the vagina without any protection, you should withdraw long before finishing and being really stimulated. Pulling out before the brink of orgasm does not protect you."

That also means that you should be putting a condom on once the penis is erect, before skin-to-skin contact.

"It's estimated that about 20% of people can get pregnant from withdrawal method during sex, so it's possible those people got pregnant from pre-ejaculate," says Dr. Hsieh.

According to the World Health Organization (WHO), the chance of conceiving from pre-cum is about 20% if you're using the withdrawal method. So, while it's low risk, it's not impossible. The WHO also notes that the most effective form of birth control is a combined oral contraceptive ("the pill") and that the only way to prevent both pregnancy and sexually transmitted infections is through the correct ad consistent use of condoms.

Is There Any Way to Prevent or Avoid Pre-Ejaculate?

There is no way to stop pre-cum, and the amount is determined by many factors. "The amount of pre-ejaculate fluid can vary depending on arousal level, hormonal status, hydration level, and medications," says Dr. Hsieh. "The only way to avoid [pre-cum] is through a barrier [e.g., condom]. People thought if a man urinates prior to sex, it can wash out the sperm from the urethra, but this is unproven."

However, if you choose to use the pull-out method, using another birth control method—like spermicidal lubricant—can help reduce the risk of pregnancy, but as with all birth control methods, it relies on proper and consistent use.

"Anything is more effective than withdrawal alone," says Dr. Creinin. "If you're putting contraceptive (spermicidal) gel in the vagina combined with withdrawal, you must follow the directions." According to the American College of Obstetricians and Gynecologists, spermicide is only 28% effective when used alone.

The Bottom Line

"Pre-ejaculate is still ejaculate—there's sperm in there," says Dr. Creinin. "The word 'pre' has got to go away." If you're looking for ways to lower your chances of becoming pregnant due to pre-cum, according to Dr. Hsieh, "Condoms are still the most reliable way."

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